Provider Demographics
NPI:1710783931
Name:ILLINOIS HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:ILLINOIS HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HASEEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEHDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-667-8844
Mailing Address - Street 1:1420 RENAISSANCE DR STE 409
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1345
Mailing Address - Country:US
Mailing Address - Phone:773-572-8520
Mailing Address - Fax:
Practice Address - Street 1:1420 RENAISSANCE DR STE 409
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1345
Practice Address - Country:US
Practice Address - Phone:773-572-8520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health